Trends Driving Healthcare Innovation

Healthcare is undergoing significant change. From falling reimbursements to rising healthcare consumerism, today’s landscape is much different than it was just a few years ago. We explore four current trends in healthcare and how they’re influencing innovation.

The Quest for Increased Efficiency

For healthcare systems around the country, achieving operational efficiency is more necessary than ever before, given falling reimbursements and tighter operating margins. In addition, federal policies incenting the move from volume-based care to value-based care are in a constant state of flux, causing uncertainty about how best to navigate the current and coming reimbursement landscape.

Health system leaders can extract maximum value from their operations by outlining and implementing evidence-based protocols for clinical care and reducing unnecessary variations in care and expense. In addition, the better matching of clinical need to clinical resource is a potential route to increased efficiency. More precisely identifying patients with, or at risk for, specific clinical conditions can allow for more judicious use of expensive diagnostic or therapeutic interventions in their management. Case in point: Predictive models that identify hospitalized patients at high likelihood for clinical decompensation can be used by proactive rapid response teams to attend to patient needs and prevent an expensive transfer to the intensive care unit.

The Rise of Healthcare Consumerism

The growing trend in healthcare consumerism highlights the need for health systems to understand and respond to the experience of their patients in a more effective fashion. Investing in a better user experience can help attract new patients and keep current ones.

For example, providing additional, customer-friendly points of access via urgent care clinics and telehealth visits can improve patient satisfaction and outcomes. Similarly, a well-designed smartphone app can direct those with minor complaints to a virtual or urgent care clinic visit, while sending those with potentially serious medical issues to the emergency department. These innovative solutions could provide avenues for more efficient and higher-value care, as well as directly impact revenue.

The Deluge of Big Data and Advanced Analytics

Healthcare innovation is not only affected by the current business realities of the healthcare system, but also by recent and ongoing developments in health data informatics and analytics. Healthcare data continues to exponentially increase in volume, driven in large part by the rapid and comprehensive adoption of electronic health records (EHRs) over the past decade. In addition, rapid advancements in genomic medicine have continued to produce important data on genetic markers and contributors to various medical conditions and diseases. As a result, there is an increasing focus on healthcare informatics, and its role in collecting and organizing these data to allow for the extraction of clinical insights to better manage individual and population care.

There is also increasing recognition that data available outside of the traditional healthcare system can provide significant insight. Patient-reported data on diet, symptoms, activity levels, and other aspects of daily life are increasingly available, thanks to wearable monitors, biosensors, and smartphone-enabled applications. Plus, environmental and social data on community health, socioeconomic status, and the availability of healthy lifestyle resources are more consistently being collected and incorporated into healthcare management and policy.

Accompanying this rise in data has been the emergence of analytic techniques to enhance the extraction of its insights. Prediction models incorporating the wide variety of genomic, clinical, patient-reported, and environmental data can more precisely target patients for early detection or treatment of health issues. Artificial intelligence (AI) algorithms can supplement healthcare provider efforts to consistently apply the latest and most relevant evidence-based care to their patients. AI can also assist in integrating expanding data streams into actionable insights for both the monitoring and diagnosis of medical conditions. Machine learning techniques can continually monitor dynamic healthcare system datasets, learning from previous outcomes to further improve insights and care for subsequent patients. In addition, these techniques can identify patterns and connections within the data that can fuel new hypotheses for medical research.

The Creation of New Care Models

A key development in healthcare innovation is the emergence of new care models. The traditional model of individual physician-patient relationships is giving way to team-based care. Several factors are driving this movement. One, physician shortages are present and increasing. Two, varied skill sets, such as those provided by nurses, pharmacists, and community health workers, are needed to effectively deliver care. Three, the emergence of EHRs facilitates effective coordination of teams. Four, the increasing amount of information needing integration for effective care delivery cannot be effectively managed by a single clinician. Finally, reimbursement models are beginning to emerge that incent team-based care. Collectively, these trends underscore the need for care delivery innovation.

These trends suggest that we must ask ourselves foundational questions regarding the current care delivery paradigm. For example, the “who” of care delivery might need re-examination. Could midlevel providers, community health workers, or other types of care providers do some of the work previously allocated to physicians? The “how” of care delivery is also worth consideration. Could the sequence, content, or technology of the care be redesigned to improve its delivery? Finally, the “where” and “when” of care may undergo transformation. As telecommunications and portable medical monitoring, diagnostic, and therapeutic devices continue to emerge, the geography of care delivery will shift. Traditional hospitals will likely shrink, and more and more care will be provided closer to where patients live and work, either in ambulatory care centers or in patients’ homes. Accompanying this will be the availability of round-the-clock care, as telecommunications and the ability to access care teams around the world render the concept of office hours moot.

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